MRI features of an infected cephalhaematoma in a neonate

Delayed and isolated oculomotor nerve palsy following minor head trauma

“…Direct oculomotor nerve injury with minor head trauma may occur at this point, as the brainstem moves downward at the time of injury, the nerve then becomes swollen, and ischemia could be caused by dural constriction at the point where the nerve pierces the dura of the cavernous sinus. [ 10 16 ] This could explain why the symptoms appeared a day after head trauma in this case.…”

“…In the present case, repeated CT and MRI did not reveal any subtle findings, including hemorrhage at the midbrain exit site of the oculomotor nerve or bending of the ipsilateral oculomotor nerve at the posterior petroclinoid ligament, which have been reported to cause isolated third nerve palsy. [ 1 10 ] In addition, absence of other associated signs and symptoms, such as hemiparesis and other cranial nerve palsies, indicated that the damage might not have occurred in the midbrain, cavernous sinus, or superior orbital fissure.…”

“…Isolated third nerve palsy without any other symptoms such as loss of consciousness or radiological abnormalities is exceptionally rare, this being the 6 th case reported in the literature [ Table 1 ]. [ 2 10 15 17 19 ] Regarding the treatment of third nerve palsy with head injury, only two of the 6 reported cases were treated with steroids. Although the site of injury to the third nerve was not clearly demonstrated, the suggested mechanism described above is supported by the effectiveness of steroid treatment for third nerve injury with minor head trauma, similar to the treatment rationale in patients with delayed facial nerve palsy.…”

Subgaleal Hematoma Masking Fatal Complications of Cephalohematoma in a Preterm Infant

“…Although routine aspiration of cephalohematomas is not indicated, radiologic imaging alone cannot differentiate between infected or noninfected cephalohematomas. 14 A diagnostic aspiration in the presence of scalp infection, sepsis, or meningitis can help guide management in these cases. 14 Incision and drainage of cephalohematoma must be followed by a course of systemic antibiotics, depending on the extent of infection.…”

MRI Diagnosis of Occipital Cephalohematoma Mimicking an Encephalocele

“…Only two case reports mention the role of MRI in differentiating infected from noninfected cephalohematoma. 8,9 MRI is reported to be the best imaging modality for defining the contents of an encephalocele prior to surgery and revealing possible associated cerebral abnormalities. 10 Because in the present case clinical suspicion of an encephalocele was relatively high, MRI was chosen.…”